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A Cost-Benefit Analysis of Case Management Activities for Diabetes - A Quasi-Experimental Study from One Medicare Advantage Plan's Perspective (Paperback)
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A Cost-Benefit Analysis of Case Management Activities for Diabetes - A Quasi-Experimental Study from One Medicare Advantage Plan's Perspective (Paperback)
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The economic and human costs of diabetes in the U.S. population
place an enormous burden on its healthcare system as well as on
employers, diabetics, and their respective families. Many Medicare
Advantage plans have responded to this burden by implementing
diabetes case management programs (DCMPs) aimed at reducing
inappropriate health services utilization, improving health
outcomes, and containing costs. While the use of DCMPs is common to
many health plans, the research regarding their effectiveness has
been sparse or inconclusive. The purpose of this study was to help
fill a critical gap in the research literature by evaluating the
effect of a diabetes case management program known as CareContact
on a Medicare population in Texas. The study population consisted
of 2,972 confirmed diabetic members who were continuously enrolled
in SelectCare of Texas, a Medicare Advantage plan, for the two-year
period between January 1, 2005 and December 31, 2006. To be
eligible for this study, diabetic members had to have a minimum of
6 months without exposure to CareContact and 6 months of exposure
to CareContact after the initial exposure. Twelve separate cohorts,
defined by date of initial program exposure, were evaluated using a
one group interrupted time series design. Cross sectional time
series analysis, which combines ordinary least square regression
techniques and time series analyses, was used to evaluate program
effectiveness. After controlling for confounders and the effects of
time, the data indicated that membership in the DCMP was associated
with increased costs and increased utilization over the two-year
study period. The study points to the need for further research
into the effectiveness of diabetes case management programs,
especially for participants of Medicare Advantage health plans.
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